1、Taenia spp.adult wormThe chain of proglottids is called the strobila,and may be composed of over 1.000 proglottids.T.saginata may measure 9 m,whereas T.solium may reach 6 m.两种带绦虫比较两种带绦虫比较 猪带绦虫猪带绦虫 牛带绦虫牛带绦虫体长体长 2-4m 4-8m2-4m 4-8m节片节片 700-1000 1-2700-1000 1-2千节千节头节头节 圆顶突小钩圆顶突小钩 方无小钩方无小钩成节卵巢成节卵巢 3 3叶叶
2、2 2叶叶孕节子宫孕节子宫 7-137-13支支 15-3015-30支支 猪带绦虫猪带绦虫 牛带绦虫牛带绦虫中间宿主中间宿主 猪猪/人人 牛牛 感染期感染期 卵卵/猪囊尾蚴猪囊尾蚴 牛囊尾蚴牛囊尾蚴 感染形式感染形式 互相互相/自体感染自体感染 互相感染互相感染 引起疾病引起疾病 绦虫病绦虫病/囊虫病囊虫病 绦虫病绦虫病 诊断诊断 粪检可查获卵粪检可查获卵肛试法肛试法 治疗治疗 吡喹酮吡喹酮/槟榔槟榔-南瓜子南瓜子The scolex of T.soliumhookletsrostullum suckersThe scolex of T.saginataGravid proglottid o
3、f T.soliumGravid proglottid of T.saginata卵（卵（EggEgg）两种带绦虫卵相似两种带绦虫卵相似类圆形类圆形卵壳薄，易破裂卵壳薄，易破裂壳内具有放射条纹的胚膜壳内具有放射条纹的胚膜含六钩蚴含六钩蚴Taenia spp.egg囊尾蚴囊尾蚴(cysticercus)(cysticercus)白色囊状物白色囊状物内含透明囊液内含透明囊液两层囊壁两层囊壁内层增厚为头节内层增厚为头节T.solium:cysticercus cellulosae with invaginated scolex孕节子宫 7-13支 15-30支Parasitic site:small
4、 intestinal眼 46 脑 40.Parasitigic site：淋巴结、脑、眼、中间宿主 猪/人 牛内囊摘除术(甲醛处理)Life cycle of Taenia saginata三、致病（Pathogenesis）加强个人防护，杜绝虫卵感染中间宿主 猪/人 牛卵囊(oocyst):内含2个孢子囊，各含4个子孢子Taenia spp.六、防治（Control）少数可见:急性淋巴结炎一、形态（Morphological features）Epidemic factorsParasitic site(Hydatid cyst):Oocvst（随粪排出)Sporozoite tachyz
5、oiteSpiramycin四、诊断（Dignosis）Life cycle of Taenia solium猪带绦虫感染期猪带绦虫感染期 绦虫病：口入含囊尾蚴的猪肉绦虫病：口入含囊尾蚴的猪肉 囊尾蚴病：口入虫卵囊尾蚴病：口入虫卵感染方式感染方式 自身感染：体内、体外自身感染：体内、体外 异体感染异体感染Life cycle of Taenia saginata807807例囊尾蚴病例囊尾蚴病眼眼 4646 脑脑 40.9%40.9%皮下皮下 6.3%6.3%肌肉肌肉 3.5%3.5%其它其它 3.2%3.2%治疗（治疗（Treatment)Treatment)带绦虫病：吡喹酮首选带绦虫病：吡
6、喹酮首选 南瓜子槟榔疗效好南瓜子槟榔疗效好 （查头节考核疗效）（查头节考核疗效）囊尾蚴病：手术摘除囊尾蚴病：手术摘除 阿苯达唑或吡喹酮阿苯达唑或吡喹酮 猪带 牛带 Parasitic site:small intestinal Infection stage:egg/cysticercusPathogenic stage:larva/adult wormEtiologic dignosis:fecal exam./perianal egg exam.Drug:Albendazole 概述概述人兽共患寄生虫病人兽共患寄生虫病畜牧区动物群中流行畜牧区动物群中流行成虫寄生于犬、狼、狐等成虫寄生于犬、
7、狼、狐等幼虫寄生于人、牛、羊等内脏幼虫寄生于人、牛、羊等内脏引起棘球蚴病引起棘球蚴病 一、形态（一、形态（Morphological Morphological featuresfeatures）1.1.成虫成虫:Minute,4-7mm in lenght;:Minute,4-7mm in lenght;Comprises of 4 segments Comprises of 4 segments scolex scolex&cervical,immature&cervical,immature、maturemature、gravid segmentgravid segment2.2.虫卵虫
8、卵:Morphologically indis-:Morphologically indis-tinguible to the Taenia eggtinguible to the Taenia eggAdult of Echinococcus granulosusRound&cystic(囊状体)Gravid proglottid of T.Oocvst（随粪排出)Sporozoite tachyzoiteintermediate host（穿刺时注意防止囊液外溢）Etiologic dignosis:Gravid proglottid of T.Gravid proglottid of T
9、.猪带 牛带Round&cystic(囊状体)四、诊断（Dignosis）Adult of Echinococcus granulosus头节 圆顶突小钩 方无小钩(包括猫科动物的非肠上皮细胞内)Albendazole：1020mg/kg,1216周In intermediate hostsIgM+：可能是新感染）；配子体：雌雄配子受精(sexual)Oocvst（随粪排出)Sporozoite tachyzoiteEpidemic factors3.3.棘球蚴棘球蚴(Hydatid cyst)(Hydatid cyst)Round&cystic(Round&cystic(囊状体囊状体)Wal
10、lWall：角皮层：角皮层(cuticle layer)(cuticle layer)、生、生发层发层(germinal layer)(germinal layer)ContentsContents：生发囊、原头蚴、子囊、：生发囊、原头蚴、子囊、孙囊（棘球蚴砂）、囊液孙囊（棘球蚴砂）、囊液Protoscoleces with double row hooklets and calcareous corpusclesHydatid sand二、二、Life cycleLife cycle EggEggAdult worm Hydatid cystAdult worm Hydatid cyst (
11、犬狼等小肠犬狼等小肠)()(人羊等肝肺人羊等肝肺)污染牧草污染牧草Life-cycle featureLife-cycle featureInfection stage:Egg(oral)Infection stage:Egg(oral)Man(or take herbivorous animals):Man(or take herbivorous animals):intermediate host intermediate hostParasitic site(Hydatid cyst):Parasitic site(Hydatid cyst):Liver Liver、lung or br
12、ain etc,lung or brain etc,单个寄生，单个寄生，可存活可存活4040年年三、致病（三、致病（PathogenesesPathogeneses）棘球蚴病或包虫病棘球蚴病或包虫病(Echinococcosis or(Echinococcosis or Hydatidosis)Hydatidosis)压迫压迫(Pressure)(Pressure)：肝、肺、脑功能障碍肝、肺、脑功能障碍过敏过敏(Allergy)(Allergy)：囊液溢出，过敏休克囊液溢出，过敏休克播散再生播散再生:囊内原头蚴侵入腹腔再发囊内原头蚴侵入腹腔再发四、诊断（四、诊断（DiagnosisDiagno
13、sis）免疫诊断免疫诊断+超声检查超声检查手术时取囊液查病原体手术时取囊液查病原体（穿刺时注意防止囊液外溢）（穿刺时注意防止囊液外溢）五、流行（五、流行（EpidemiologyEpidemiology）分布：森林型、畜牧型分布：森林型、畜牧型流行因素流行因素:犬粪污染牧草、水土犬粪污染牧草、水土 人犬密切接触人犬密切接触 病畜内脏管理不善喂狗病畜内脏管理不善喂狗六、防治原则六、防治原则（Principles of Principles of controlcontrol）加强个人防护，杜绝虫卵感染加强个人防护，杜绝虫卵感染处理好病畜内脏处理好病畜内脏定期为牧犬治疗定期为牧犬治疗Surgica
14、l removal:Surgical removal:内囊摘除术内囊摘除术(甲醛处理甲醛处理)AlbendazoleAlbendazole：1020mg/kg,/kg,1216周周弓形虫概述弓形虫概述世界性分布世界性分布人畜共患人畜共患寄生温血动物和猫科动物寄生温血动物和猫科动物机会致病机会致病一、一、MorphologyMorphology 1.In 1.In intermediate hosts(人或温血动物有核细胞内人或温血动物有核细胞内)TachyzoiteTachyzoite：弓形：弓形,内二芽殖内二芽殖,胞胞内繁殖内繁殖(假包囊假包囊,preudocyst),preudocyst)
15、CystCyst：有囊壁，内含大量：有囊壁，内含大量 缓殖子缓殖子(bradyzoite)(bradyzoite)In cell cultures,T.gondii proliferates to form a pseudocyst of 8-20 parasites.Gravid proglottid of T.Contents：生发囊、原头蚴、子囊、Gravid proglottid of T.The chain of proglottids is called the strobila,and may be composed of over 1.Adult worm Hydatid cy
16、st(犬狼等小肠)(人羊等肝肺)Pyrimethamine+Sulfadizines壳内具有放射条纹的胚膜(犬狼等小肠)(人羊等肝肺)病畜内脏管理不善喂狗壳内具有放射条纹的胚膜头节 圆顶突小钩 方无小钩Parasitigic site：淋巴结、脑、眼、Gametocyte （人，动物）卵囊(oocyst):内含2个孢子囊，各含4个子孢子流行因素:犬粪污染牧草、水土水平传播:口入、输血、伤口等(包括猫科动物的非肠上皮细胞内)Parasitigic site：淋巴结、脑、眼、Parasitic site:small intestinalT.gondii:lysis of a THP-1 cell
17、with release of tachizoites in culture.T.gondii:tissue cysts,100-300 m,may contain up to 3 000 bradyzoites.Tachyzoites of Toxoplasma gondii in macrophages of mouse in peritoneal exudate.(SEM)2.In definitive host猫科动物小肠上皮细胞内猫科动物小肠上皮细胞内裂殖体：裂殖体：AsexualAsexual配子体：雌雄配子受精配子体：雌雄配子受精(sexual)(sexual)卵囊卵囊(oocy
18、st):(oocyst):内含内含2 2个孢子囊，个孢子囊，各含各含4 4个子孢子个子孢子二、二、Life cycleLife cycle特点：两类宿主，两种生殖方式特点：两类宿主，两种生殖方式猫科动物猫科动物:definitive host-:definitive host-配配 子生殖子生殖人或其它温血动人或其它温血动物物:intermediate :intermediate host-host-无性生殖无性生殖(包括猫科动物的非肠上皮细胞内包括猫科动物的非肠上皮细胞内)Oocvst（随粪排出（随粪排出)Sporozoite tachyzoite 合子合子 Gametocyte （人，动物
19、）（人，动物）Schizont Cyst(猫猫)(Bradyzoite)(Bradyzoite)生活史要点生活史要点Infection stageInfection stage：oocystoocyst，cystcyst，tachyzoitetachyzoiteInfection modeInfection mode：垂直传播垂直传播:胎盘胎盘(Mother Children)(Mother Children)水平传播水平传播:口入、输血、伤口等口入、输血、伤口等Parasitigic siteParasitigic site：淋巴结、脑、眼、：淋巴结、脑、眼、肌肉、肝、心、肺等肌肉、肝、心、
20、肺等三、三、致病（致病（PathogenesisPathogenesis）1.机制机制Tachyzoite:细胞内增生与破坏细胞内增生与破坏Cyst:Cyst:累及重要脏器、组织累及重要脏器、组织代谢物致变态反应代谢物致变态反应2.Clinical types2.Clinical types1)Congenital toxoplasmosis:1)Congenital toxoplasmosis:四联症四联症 视网膜脉络膜炎视网膜脉络膜炎 脑积水脑积水 脑钙化脑钙化 小头畸形小头畸形壳内具有放射条纹的胚膜Infection stage:egg/cysticercusTaenia spp.Ooc
21、vst（随粪排出)Sporozoite tachyzoiteTachyzoites of Toxoplasma gondii in macrophages of mouse in peritoneal exudate.重症型，全身性感染,预后差Pathogenic stage:trophozoite人或其它温血动物:intermediate自身感染：体内、体外Taenia spp.(犬狼等小肠)(人羊等肝肺)Round&cystic(囊状体)五、流行（Epidemiology）Parasitic site:small intestinalGravid proglottid of T.免疫学:测
22、抗体（IgG+：有感染；幼虫寄生于人、牛、羊等内脏Adult of Echinococcus granulosus肌肉、肝、心、肺等intermediate hostoocyst，cyst，tachyzoiteCyst：有囊壁，内含大量2)Acquired toxoplasmosis2)Acquired toxoplasmosis(In immuno-competent hosts)(In immuno-competent hosts)多数无症状多数无症状:90%90%suppressive infectionsuppressive infection少数可见少数可见:急性淋巴结炎急性淋巴结炎
23、 视网膜脉络膜炎；视网膜脉络膜炎；罕见肺炎罕见肺炎,肝炎肝炎,心肌炎心肌炎,脑膜脑炎脑膜脑炎 隐性感染激活，发病隐性感染激活，发病 重症型，全身性感染重症型，全身性感染,预后差预后差2)Acquired toxoplasmosis2)Acquired toxoplasmosis (In immuno-incompetent hosts)(In immuno-incompetent hosts)四、四、诊断诊断（Dignosis）病原学病原学:组织体液活检组织体液活检,涂片染色涂片染色 动物接种分离、细胞培养、动物接种分离、细胞培养、PCRPCR测弓形虫测弓形虫DNADNA免疫学免疫学:测抗体（
24、测抗体（IgGIgG+：有感染；：有感染；I IgMgM+：可能是新感染：可能是新感染）；测抗原测抗原五、五、流行（流行（EpidemiologyEpidemiology）1.Epidemic factors1.Epidemic factors传染源传染源:猫、家畜和野生温血动物猫、家畜和野生温血动物传播途径传播途径:Man Man （胎盘，输血）（胎盘，输血）ManMan Animal Animal （肉食品，水）（肉食品，水）ManMan Animal Animal （食肉）（食肉）AnimalAnimal2.Epidemic fectureEpidemic fecture生活史多期均有传
25、染性生活史多期均有传染性宿主、寄生部位要求不严格宿主、寄生部位要求不严格中间宿主间可相互传播中间宿主间可相互传播组织内包囊存活长组织内包囊存活长,卵囊抗力大卵囊抗力大猫为主要传染源猫为主要传染源(粪便内卵囊污染粪便内卵囊污染)六、六、防治（防治（ControlControl）治疗患者：治疗患者：Drugs:Drugs:Pyrimethamine+Sulfadizines Pyrimethamine+Sulfadizines Spiramycin Spiramycin预防为主：预防为主：no consume undercooked meatno consume undercooked meat严
26、格个人卫生及食品卫生要求严格个人卫生及食品卫生要求孕妇防止与猫接触、产前检查孕妇防止与猫接触、产前检查 E.h.Parasitic site:intestinal wall Infection stage:4 nuclei cyst Pathogenic stage:trophozoite Etiologic dignosis:stool examination Drug:metronidazole Gravid proglottid of T.solium二、二、Life cycleLife cycle EggEggAdult worm Hydatid cystAdult worm Hyda
27、tid cyst (犬狼等小肠犬狼等小肠)()(人羊等肝肺人羊等肝肺)污染牧草污染牧草Infection stage:4 nuclei cystLife-cycle feature猫科动物:definitive host-配Etiologic dignosis:Albendazole：1020mg/kg,1216周Infection mode：Man(or take herbivorous animals):人或其它温血动物:intermediate寄生温血动物和猫科动物头节 圆顶突小钩 方无小钩Pathogenic stage:larva/adult worm视网膜脉络膜炎；裂殖体：Asex
28、ualIn cell cultures,T.Epidemic fectureDrug:metronidazolegondii:lysis of a THP-1 cell with release of tachizoites in culture.动物接种分离、细胞培养、PCR测弓形虫DNAIn cell cultures,T.重症型，全身性感染,预后差压迫(Pressure)：肝、肺、脑功能障碍Tachyzoites of Toxoplasma gondii in macrophages of mouse in peritoneal exudate.四、诊断（四、诊断（DiagnosisDi
29、agnosis）免疫诊断免疫诊断+超声检查超声检查手术时取囊液查病原体手术时取囊液查病原体（穿刺时注意防止囊液外溢）（穿刺时注意防止囊液外溢）五、流行（五、流行（EpidemiologyEpidemiology）分布：森林型、畜牧型分布：森林型、畜牧型流行因素流行因素:犬粪污染牧草、水土犬粪污染牧草、水土 人犬密切接触人犬密切接触 病畜内脏管理不善喂狗病畜内脏管理不善喂狗T.gondii:lysis of a THP-1 cell with release of tachizoites in culture.2.In definitive host猫科动物小肠上皮细胞内猫科动物小肠上皮细胞内裂
30、殖体：裂殖体：AsexualAsexual配子体：雌雄配子受精配子体：雌雄配子受精(sexual)(sexual)卵囊卵囊(oocyst):(oocyst):内含内含2 2个孢子囊，个孢子囊，各含各含4 4个子孢子个子孢子oocyst，cyst，tachyzoitestool examinationno consume undercooked meatintermediate hostgondii:lysis of a THP-1 cell with release of tachizoites in culture.3%肌肉 3./perianal egg exam.Round&cystic
31、(囊状体)人或其它温血动物:intermediateTachyzoites of Toxoplasma gondii in macrophages of mouse in peritoneal exudate.Etiologic dignosis:五、流行（Epidemiology）内囊摘除术(甲醛处理)子生殖Albendazole：1020mg/kg,1216周Oocvst（随粪排出)Sporozoite tachyzoiteProtoscoleces with double row hooklets and calcareous corpuscles南瓜子槟榔疗效好Round&cystic
32、(囊状体)Parasitic site:intestinal wallSchizont CystGravid proglottid of T.内囊摘除术(甲醛处理)诊断 粪检可查获卵肛试法The chain of proglottids is called the strobila,and may be composed of over 1.intermediate hostEtiologic dignosis:（查头节考核疗效）猫科动物小肠上皮细胞内一、形态（Morphological features）二、Life cycleLife cycle of Taenia solium囊尾蚴病：
33、口入虫卵Etiologic dignosis:Tachyzoite:细胞内增生与破坏Gravid proglottid of T.传染源:猫、家畜和野生温血动物Clinical typesInfection stage:Egg(oral)五、五、流行（流行（EpidemiologyEpidemiology）1.Epidemic factors1.Epidemic factors传染源传染源:猫、家畜和野生温血动物猫、家畜和野生温血动物传播途径传播途径:Man Man （胎盘，输血）（胎盘，输血）ManMan Animal Animal （肉食品，水）（肉食品，水）ManMan Animal Animal （食肉）（食肉）AnimalAnimal
